Wednesday, July 23, 2014

SAN JOSE CR II: A pleasant surprise

WEDNESDAY:  CHOOSING A GOOD PRACTICE at a distance might seen somewhat of 'pig in a poke' exercise.  I did the best I could (more details later) with two practices in mind, one I was fairly sure of and the other, also promising, as a backup.  Imagine how it might feel to travel to a distant county and not to like what one discovers.  With governments backing dental tourism there is room for lots of hype and possibly practitioners of dubious competence but gifted with advertising elan getting into the market place.

As it turned out, I liked what I saw at Costa Rica Dental Team.  Paul, the client coordinator, did indeed pick me up in good time to take me to the offices.  As everywhere, there were forms to fill in at the outset. Then it was off to the first examination consisting a detailed examination that included using a special camera to take several views of each tooth.  This showed up some questionable shadows at the margin of two crowns, one of which seemed serious enough to take preventive replacement of one crown.  The  molar that might have needed a root canal did not yield any more information and we agree that the endodontist due to visit the next day would provide the final opinion (which was that a prophylactic root canal would be in order).  Over that last two days I have been moving through a maze of replacement of crowns, root canal, cleanings, consultation with the oral surgeon about the implants, x-rays, and various other stuff.  All very boring, no doubt, but altogether an impressive demonstration of how a dental team can go about providing excellent service.

There are quite a lot of women dentists in CR and I think they bring quite a different approach to care.  Mike, the owner of the practice, has a preference to employ women at all levels and I think this is a good strategy.  He is an American trained as a Dental Technician who, for much of his early career, ran a laboratory for a large practice.  He had opportunity to acquire clinical knowledge through working alongside the dentists and to see the connections between clinical and technical aspects of advanced dentistry.  The next step was to set up a laboratory of his own, eventually in Florida although he originates in Michigan.  He received work from all over the US and finally moved his laboratory to San Jose, the distribution center remaining in Miami. The laboratory is his main business stream, serving 800 US dental practices.

Prosthetic and cosmetic dentistry is more an add-on, using a core team and bringing in specialists according to patient needs.  He stands behind the work, giving a 10 year guarantee.  The oral surgeon has his own practice, where Paul took me for the necessary imaging.  Altogether, I think this is a neat way to package professional services.  Permanent crowns are to be fitted this afternoon, leaving the oral surgery and placement of the implants for tomorrow.

To date, I have been very busy with the dental stuff but yesterday I had enough free time to walk do the down town area...about a half hour's distance.  Recall that SJ is at almost 4000 ft elevation and quite hilly and it is enough to say that I have learned a respect for the macro terrain. At the more micro level one must watch the steps and the unevenness of most of the sidewalks and smaller streets.  These seem to have been in constant repair for the last century or so and lagging the wear and tear.  More importantly, watch out for the drivers who have scant, if any, respect for pedestrians!  The streets are narrow and traffic thick, so their eyes are not focused on people trespassing the road.  To give the drivers their due, pedestrians seem singularly unconcerned about risk, most often just stepping out into traffic with nary a glance.

At town center pedestrian conditions improve, better pavements and good use of pedestrian malls.

How to describe SJ? An old city becoming  new with vestigial traces of the old and the interim all around. Of course, the people are wonderfully friendly and helpful. Very few know English so do some work on Spanish before you come here.

I am just back from having the final crowns fitted.  They have done an excellent job of preparing and fitting them.  Jessica, my dentist, sang along with the music a good part of the time....there's added value for you!

This evening, I plan to go down to the corner to the Irish Pub for a glass or two of Irish whiskey.  Tomorrow, they drill the sites for the three implants and screw them in.  Not looking forward to this.  More on this in the next posting.




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